Annals of Indian Academy of Neurology
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A practical approach to the diagnosis and management of optic neuritis

1 Department of Surgery in Ophthalmology, University of Calgary, Calgary, AB, Canada
2 Department of Surgery in Ophthalmology; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada

Correspondence Address:
Fiona Costello,
7007 14 St SW, Calgary, AB T2V 1P9, Calgary, Alberta
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aian.aian_170_22

Optic neuritis (ON), as an umbrella term, refers to a spectrum of inflammatory optic neuropathies arising from a myriad of potential causes. In its most common form, “typical” ON presents as a unilateral, painful subacute vision loss event in young Caucasian women. The Optic Neuritis Treatment Trial (ONTT) has historically guided our treatment of ON, and taught us important lessons about the clinical presentation, visual prognosis, and future risk of multiple sclerosis (MS) diagnosis associated with this condition. However, in the decades since the ONTT, several immune-mediated conditions such as neuromyelitis optica spectrum disorder (NMOSD), and myelin-oligodendrocyte glycoprotein IgG associated disease (MOGAD) have been discovered, complicating the clinical approach to ON. Unlike MS, other central nervous system (CNS) inflammatory conditions are associated with ON subtypes that are potentially blinding, and prone to recurrence. Owing to differences in the clinical presentation, serological biomarkers, radiological findings, and prognostic implications associated with MS ON, NMOSD ON, and MOGAD ON subtypes, it is imperative that clinicians be aware of the diagnostic approach and management options for these conditions.

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